More than 50 years after a doctor at a Roman clinic began promoting hCG as a dieting aid, it is as popular as ever, even though there is scant evidence that it makes any difference. The regimen combines daily injections with a near-starvation diet, and patients, mostly women, are often enticed by promises that they can lose about a pound a day without feeling hungry.

In response to inquiries stirred up by the diet's popularity, the FDA warned in January that "homeopathic" forms of hCG, like lozenges and sprays, sold over the Internet and in some health food stores, are fraudulent and illegal if they claim weight-loss powers.

Doctors who prescribe hCG for dieting say that experience is in their favor, even if the research is not.

Dr. Mercola's comments

For several years, many have asked me about the hCG (human chorionic gonadotropin) diet. It's time to present you with some information on hCG, but keep in mind that it's not something I would recommend as a "first-line approach" to achieving your ideal weight. My first reaction to the hCG diet was one of skepticism. But when one of my primary nutritional mentors—Harvard Medical School graduate and natural medicine pioneer Dr. Jonathan Wright—found it to be useful in his clinic, I decided it deserved a more careful review. But before I get into the specifics about hCG, I want to emphasize what I consider to be the foundation of your health—which is more important than hCG or any other short-term dietary protocol.

If you've been reading my newsletter for a while, you may have noticed I often END my articles by summarizing my recommendations. However, in this case, I am going to start with those recommendations—because basic lifestyle changes should be what you implement first, before considering hCG or any other diet plan.

Address these things first before and during any weight loss program

The vast majority of you who are diligent about making the basic changes I'm about to outline will be able to successfully lose weight in a safe and healthy way and experience lifelong success at maintaining your ideal weight, because you will have addressed key underlying lifestyle and emotional issues that were keeping you stuck.

This truly works for the vast majority of people who try it! So please, don't gloss over it. Really evaluate your current habits, and identify where you may still be lagging.

I have seen tens of thousands of people successfully lose weight simply by applying the following eight foundational principles:

• The foundation of your nutritional plan should be eating for your Nutritional Type—beginning with taking my FREE Nutritional Typing test—then modifying your diet appropriately.
• Eliminate processed foods, sugar, and starches, and replace them with fresh raw organic vegetables, organic meat and eggs. You should stick to these principles whether you employ the hCG diet or not, so that your foods are as nutrient-dense as possible.
• Also reduce your grains and fruits, as their sugars will contribute to the insulin resistance that makes it difficult for you to metabolize fat properly.
• Replace soda, fruit juices, and other caloric beverages with plenty of pure water every day. Increased water intake has been shown to accelerate weight loss.
• Incorporate plenty of exercise, and make sure you include high-intensity burst-type exercises like Peak 8, which are far superior than any other exercise for boosting weight loss naturally.
• Make sure you're getting adequate restorative sleep.
• Manage your stress. Adopt a technique like EFT (Emotional Freedom Technique), which can help you nip cravings in the bud.
• Whenever you are reducing weight and breaking down body fat, it's important to incorporate some sort of detoxification program. Your body stores many toxins inside fat cells, and when you break those down, toxins naturally enter your bloodstream and can actually make you feel sick if you don't take steps to "mop them up." One of my favorite detox aids is chlorella.

Exercise is every bit as important as what you eat—NO exceptions—regardless of your Nutritional Type, age, gender, lifestyle, or level of health. A regular exercise routine is crucial for countless aspects of your health, beyond fitness and body weight—even if it means starting with just 5 minutes per day.

When taking a "lifestyle inventory," you may be surprised to find one little area you've ignored, which, if you made some simple changes, might totally change your situation. For example, something as simple as cutting out all soda and sweetened beverages could easily be the tipping point that makes your excess pounds suddenly begin to fall off! That said, let's review the hCG diet.

HCG - the pregnancy hormone

HCG stands for "human chorionic gonadotropin," which is a large glycoprotein, consisting of 244 amino acids, produced in huge amounts by the placenta during pregnancy. It's not technically a hormone, although you will often hear it called one. HCG's role is to maintain the integrity of the corpus luteum of a pregnant woman's ovary in order for her to produce the hormone progesterone, which is essential to her growing fetus. In fact, hCG is actually what is being measured when you do a pregnancy test. Just to be clear, hCG is not the same thing as HGH—it's important to not confuse the two.

HGH is human growth hormone, which also plays a major role in your metabolism. However, HGH is produced by your pituitary gland, particularly at night while you sleep and in response to high-intensity, burst-type exercises that engage your super-fast muscle fibers.

Increasing your natural HGH production is one of the reasons I am such a strong advocate for incorporating Peak 8 exercises into your total health plan—it's especially effective for weight loss. Please make some time to review my Peak 8 video so you can make this a part of your weekly workout routine.

It all began With Dr. Simeons

British endocrinologist A.T.W. Simeons spent 30 years of his life seeking a "cure" for obesity. His research led him to investigating the links between endocrinology, obesity and psychosomatic disorders, eventually concluding that the key to the obesity problem lies within the part of your brain called the diencephalon, which includes your thalamus and hypothalamus.

Dr. Simeons' mission was to find a way to correct the diencephalic deficiency that he believed leads to the accumulation of excess body fat. In an excellent article, Sherrill Sellman, ND, explains that Dr. Simeon's "Eureka moment" came when he noticed very thin pregnant Indian women delivered healthy full-weight babies, despite their low calorie diets and demanding physical activities.

These pregnant women readily dropped weight with shockingly low dietary intake—but without hunger or any damage to their unborn babies. After much research, he attributed this phenomenon to the abundance of hCG in their bodies.

Simeons hypothesized that hCG was acting on the hypothalamus of these pregnant women, telling it to mobilize maternal fat stores to protect and nourish the developing fetus.

Dr. Simeons then observed that obese young Indian boys with a rare medical condition (Frohlich's Syndrome, or adiposogenital dystrophy) were cured of their obesity with daily injections of tiny doses of hCG. They miraculously lost their ravenous appetites and their bodies "reshaped" to normal.

These unexpected findings led Dr. Simeons to wonder if hCG could be used to stimulate the breakdown of abnormal fat reserves in non-pregnant women and men, thereby reducing obesity. So he began experimenting with his patients.

Simeons discovered that daily hCG injections, when combined with a very specific low fat and low calorie diet (500 calories a day), resulted in astonishing weight loss—and in particular, fat loss. In fact, he reported that almost 100 percent of his test patients lost between one-half pound and one pound of body fat per day on his protocol.

Could it be that hCG was resetting the hypothalamus? Or was it merely the severe caloric restrictions that led to the dramatic loss?

The scientific studies thus far are inconclusive (many of which are cited in a later section of this article).

How your hypothalamus controls your weight

Your hypothalamus is a collection of specialized cells located in the central part of your brain, facilitating communication between your endocrine system and your central nervous system. Your hypothalamus is integrally involved in your cardiovascular function, water balance, body temperature, sleep, metabolic processes—and fat storage.

Your hypothalamus works in conjunction with your pituitary gland to control ALL of your hormones, so it's a very important part of your body's overall functioning.

Your appetite and thirst are also controlled by signals sent from your hypothalamus.

If this part of your brain falls out of balance—which happens in response to stress, trauma, toxins, electromagnetic fields, yoyo dieting, etc.—you can experience excessive hunger, impaired metabolism, and accumulation of fat in various parts of your body such as your abdomen, hips, thighs, upper arms, and waist.

Getting your calories from your own extra fat stores

Dr. Simeons' weight loss theory hinges on a different way of categorizing adipose tissue. In modern medical literature, you will see body fat categorized into only two types—visceral fat and subcutaneous fat.

But Dr. Simeons believed there were three types of fat in the human body:

• Structural fat: This "good fat" protects your major organs and joints; it is ordinarily NOT burned for energy.
• Normal fat reserves: Also "good fat," this type of fat is spread throughout your body to, ideally, be burned when your body needs immediate fuel. It's your regular gas tank.
• Abnormal stored fat: Also called adipose fat, this type of fat is not needed and is what accumulates when a person becomes obese. It is stored underneath your skin and around your organs as a spare fuel supply, causing those unsightly bumps and buldges. Your body makes this as a final survival strategy should you become malnourished.

       

It is problematic that Dr. Simeons doesn't state how he arrived at his three fat types, since he doesn't cite any scientific data explaining his classification scheme. But, assuming for a moment that we do have these three kinds of fat, this is how he proposed the hCG exerts its effects.

He theorized that the hCG directs your body to hang on to the good fat (the structural and normal fat reserves), while using your abnormal fat for fuel.

This process is kicked into operation with caloric restriction, as your body is sent into an energy deficit by the very low calorie diet. Your body is forced to use your fat reserves for fuel. With hCG, your body transforms your abnormal fat into 1,500-3,000 calories a day of energy and nutrition.

The more stored fat you have, the greater the daily fat loss.

According to hCG proponents, people are generally not hungry when they are using HCG because of the calories provided by the burning of these fat reserves. They also claim that the protocol "resculpts" the body into its optimal shape because the bulgy areas are the places that are reduced.

Of course, this assumes you make permanent lifestyle changes and avoid resuming bad habits. As successful as the weight loss may be for those who use the hCG diet, there are equal numbers of individuals who gain the weight back when they return to their former, unwise lifestyle habits.

One example of HCG success

A woman in her 40s had been following my nutritional and exercise guidelines for several years, yet continued to gain weight (and body fat) in spite rigid adherence to my program.

She was then unexpectedly diagnosed with a pituitary adenoma, which is a type of benign pituitary tumor that can affect major hormone pathways, including human growth hormone (HGH). A comprehensive medical workup showed she was producing almost no HGH. HGH is a major player in keeping your metabolism up.

In a "last ditch effort," her physician prescribed the hCG diet.

She experienced moderate weight loss success on the hCG protocol and had no adverse effects from the diet, and in fact felt pretty good. She was even able to sustain most of her exercise program during the temporary 500-calorie phase, although she had to back down a little on the intensity.

So far, she's kept the weight off.

It's important to realize that her success was most likely not just due to the hCG weight loss phase that includes a very austere 500 calories a day diet, but also from paying close attention to the BASIC nutritional guidelines outlined above, such as exercise and eliminating practically all sugar and starches from her diet. Those 500 calories were nutrient-dense, and not junky carb calories…

This is an example of one extreme case in which the hCG protocol was successfully used along with my basic nutritional principles.

However, as with ANY weight loss plan, you must be willing to make permanent changes if you hope to keep weight off. Otherwise, you will not only put the fat back on in a hurry, but you will stress your metabolism in such a way that it will be even MORE difficult to drop weight in the future.

Remember, the vast majority of you do not fit into the same category as this patient, who's pituitary tumor led to her decision to experiment with hCG at the suggesion of her physician. But if you do choose to try it, I strongly urge you to do so ONLY under the guidance and monitoring of a trusted professional.

Potential side effects of HCG

Side effects from the hCG injections can include temporary water retention, breast swelling and tenderness among other things. The 500-calorie phase of the hCG diet can cause fatigue, constipation, muscle cramps, hunger and low blood sugars.

The FDA reports one case of a pulmonary embolism possibly related to the hCG diet.

The amount of hCG injected (125 IU) is a very small fraction of the amount a pregnant woman produces (as high as 200,000 IU).

Because you use hCG in conjunction with extreme calorie restriction, the hCG phase is limited to either 23 or 40 days, depending on the amount of weight you need to lose. And there are preparatory steps prior to the very low calorie diet, as well as a protocol to follow afterward as you transition back into a normal eating routine.

Many health practitioners have expressed concern about potential adverse effects from such severe caloric restriction.

Indeed, a 500-calorie diet is NOT something you would want to do for very long due to the potential for malnourishment and other adverse effects. This is why the hCG diet is done for only 23 to 40 days, and if people wish to lose more weight, they are instructed to take a break before doing another "round."

Every person's tolerance and biochemistry is different, and not everyone will tolerate this type of extreme protocol!

That said, there are many who report doing well on the hCG diet, with no adverse effects.

As with any treatment (this is more of a treatment than a diet), you should listen to your body, and make sure you're monitored by a qualified health care practitioner.

What the research shows

There remains a fair amount of controversy surrounding the weight loss actions of hCG.  The preponderance of research studies show no advantage of hCG over placebo.

Most clinical trials in which patients received either hCG injections or placebo and followed identical very low calorie diets showed no difference in amount of weight lost, type of weight lost, hunger level, or mood. There are exceptions, but they are few. This may mean that the severe calorie restriction is the real key to the success of this diet. Your BELIEF that it will work might also be a contributing factor.

For the sake of completeness, the following are a few studies I ran across in my research. Bear in mind however, that the studies using actual HCG might not be indicative if you're using homeopathic HCG, either for better or worse…

On the positive side:

• W Asher and H Harper. "Effect of human chorionic gonadotrophin on weight loss, hunger, and feeling of well-being." Am J Clin Nutr. 1973;26(2):211-8

  This study found more weight was lost in the HCG group than the placebo group; also found hunger was decreased and feelings of wellbeing were greater.

• AT Simeons. "The action of chorionic gonadotrophin in the obese." Lancet. 1954 Nov 6;267(6845):946-7

  Not even an abstract was available online, but Dr. Simeons has several studies published back in the 1950s and 1960s that can be ordered in hard copy.

On the negative side:

• S Lijesen, et al. "The effect of human chorionic gonadotropin (hCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis." Br J Clin Pharmacol 1995;40:237-243

  This was a meta-analysis of 8 uncontrolled and 16 controlled trials concluding that there is no scientific evidence that hCG is effective in the treatment of obesity, in terms of fat redistribution, weight loss, suppression of hunger, or increased feelings of wellbeing.

• FL Greenway and GA Bray. "Human chorionic gonadotrophin (hCG) in the treatment of obesity: a critical assessment of the Simeons method." West J Med. 1977;127(6);461-3

  Researchers concluded, "Placebo injections appear to be as effective as hCG in the treatment of obesity."

• RL Young, et al. "Chorionic gonadotrophin in weight control. A double-blind crossover study." JAMA. 1976;236(22):2495

This double blind controlled study was performed on 202 individuals, and researchers found no statistically significant difference between subjects receiving hCG and those receiving placebo.

Final thoughts and suggestions

It is important to recognize that there is no "magic bullet" for weight loss, and this is one of the primary reasons why I cannot, in the end, endorse the hCG diet.

If you are among the 2/3 of the population that is overweight, I would strongly recommend first severely limiting starchy carbohydrates, grains and sugars as they tend to increase insulin resistance, which makes it virtually impossible to lose weight.

If you are not getting the results you need, you might want to consider products I have found useful, like Biothin and conjugated linoleic acid (CLA), both of which contain safe ingredients and have established science behind them. Additionally, I would urge you to work up to a high intensity exercise program like Peak 8. This may be THE most important missing factor in your weight loss plan.

Using those two supplements, along with carbohydrate and sugar restriction, exercise, and the other recommendations I've discussed, has been shown to work for the majority of people trying to lose weight.

I believe that the extreme low-calorie, low-fat intake required during the hCG weight loss phase is simply too severe, and could pose unnecessary health risks. Additionally, I couldn't picture myself doing Peak 8 exercises on that kind of restriction, and that effectively eliminates your most potent—and absolutely proven—weight loss aid.

Additionally, this diet does nothing to change the lifestyle habits that sent your weight ballooning in the first place, and there's no evidence it actually helps you keep the weight off long-term.

Lastly,  the science behind hCG is not definitive and, as a result, I don't recommend the HCG protocol. I strongly believe the other methods I have described are far superior, and would be your best and primary approach.